Biomedical subjects

J C Clyde

Publications and source records attributed to J C Clyde.

3 recordsLinked to original sources

PubMed1998

Accuracy of stereotactic core-needle breast biopsy in atypical ductal hyperplasia.

BACKGROUND: The histologic diagnosis of atypical ductal hyperplasia (ADH) has been reported as having a high rate of malignancy, either ductal carcinoma in situ (DCIS) or invasive ductal carcinoma (IDC). We reviewed our surgical group's experience with stereotactic core-needle biopsies (SCNB), specifically looking at the follow-up of ADH. METHODS: From November 1994 through July 1997 our group performed 539 SCNB. Twenty-one patients (4%) were diagnosed as ADH. Eighteen patients had subsequent wire-localized excisional biopsies. Three patients were followed up mammographically. One patient refused follow-up. RESULTS: Of the 18 patients who underwent excisional biopsies, 2 patients were found to have DCIS and 1 patient had lobular carcinoma in-situ. There were no cases of IDC. CONCLUSION: Our results show a much lower incidence of malignancy in cases of ADH found on SCNB than has been previously reported. While the standard of care is still to follow up ADH found on SCNB with excisional biopsy, more data may justify following up certain subsets of patients.

Biopsy, Needle↗

PubMed1995

Treating esophageal cancer with a combination of chemotherapy, radiation, and excision.

BACKGROUND: Treatment of esophageal cancer has been primarily palliative. Recent studies have shown that preoperative combination chemo- and radiation therapy increases the effectiveness of surgical excision. PATIENTS AND METHODS: Beginning in 1990, 29 patients in the Spokane area were treated with preoperative chemo- and radiation therapy. They were 23 men and 6 women whose mean age was 66 years. Twenty-five had adenocarcinoma, of whom 3 had Barrett's esophagitis. Four had squamous cell carcinoma. The chemotherapy included fluorouracil, cisplatin, and vinblastine. Radiation was given concomitantly, BID for 21 days. Surgical excision was performed about 3 weeks after the last radiation session, pending recovery from cytopenia. RESULTS: There was 1 operative death, for an operative mortality of 3.4%. Twenty-three patients (79%) were found to have no residual cancer at the time of resection. Of this group, 8 died of metastatic cancer at a mean of 15 months postoperatively (range 1 to 28), and 15 were alive at a mean of 28 months (range 12 to 46). Six patients (21%) had residual cancer in the resected specimen, either at the primary site or--more often--in adjacent lymph nodes. Five have died at 6, 8, 9, 24, and 28 months postoperatively; 1 remains alive at 14 months. The mean survival among these 6 patients is 15 months. CONCLUSIONS: Combined chemo- and radiation therapy prior to esophagectomy appeared to improve outcome in this small series of patients with esophageal cancer. Local control was excellent, but distant metastasis continues to be a significant problem.

Adenocarcinoma↗

PubMed1991

Laparotomy and multiple system organ failure.

A retrospective review of laparotomies was undertaken to define the indications for abdominal procedures in patients with multiple system organ failure. This study suggests patients with (MSOF) must be thoroughly evaluated with non-invasive technology to determine the presence of an intra-abdominal septic focus prior to consideration of exploratory laparotomy.

Abdomen, Acute↗